Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Simmons NURP 503 Exam 2 > 6: Screening > Flashcards

6: Screening Flashcards

1
Q

What should be done during 9 month check up visit? What anticipatory guidance will you provide?

A
  • Comprehensive history~include oral health assessment (evaluate risk factors for caries)
  • At all visits, perform developmental surveillance by asking parents if they have any concerns about the child’s development.
  • Start formal developmental screening during the 9-month visit using a validated tool such as Parents’ Evaluation of Developmental Status (PEDS)
  • Unclothed physical exam
  • Include all three growth parameters (weight, length, and head circumference).
  • The unclothed requirement is a federal requirement to meet EPSDT standards and must be clearly documented
  • Vision screening~Ask parent’s appraisal of vision every visit, and refer for further testing if there are any concerns.
  • Hearing screening~ask parent’s appraisal of hearing every visit, and refer for further testing if there are any concerns.
  • Lab testing and screening~ consider hemoglobin (Hb) screening at this visit (or definitely screen at 12 months).10
  • Immunizations
  • Health education and anticipatory guidance~Injury prevention

Violence prevention, Nutrition counseling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the A1C goal in general?

A

7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a positive lead level, and what do you do about it?

A

● Normal is less than 5 mcg/dL

● In 2012, the CDC changed their definition of acceptable lead level to reflect the 97.5% of all blood lead levels of children in the US. Any level above 5 mcg/dL is abnormal and needs to be repeated (see CDC recommendations regarding frequency based on level); and levels above 69 mcg/dL require chelation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which screening tests are performed in the newborn nursery?

A
  • Newborn Screen- All states require sickle cell disease, PKU, hypothyroidism, and cystic fibrosis screening.
  • Critical congenital heart defect (CCHD) screening
  • Hearing screening
  • Hyperbilirubinemia screening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who should be screened for DMT1?

A

Screening is not recommended. Check only individuals with symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Immunization recommendations for DM?

A

Flu and pneumococcal (age appropriate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What universal screening is done at the 12-month visit?

A
  • Comprehensive history
  • Unclothed physical exam
  • Vision screening (instrument-based screening may be used at 12 and 24 months)
  • Hearing screening (ask about concerns)
  • Immunizations
  • Health education and anticipatory guidance
  • Oral Health
  • Lab testing and screening~Hemoglobin (if not performed at 9-month visit~Universally checked at (9 or) 12 months to evaluate for iron-deficiency anemia
  • TB risk assessment
  • lead risk assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Who should be screened for DMT2 (2)?

A
  1. Adults with BMI >25.
  2. Overweight children (weight/length >85%).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when should children be assessed for TB risk?

A

12 months and then yearly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antiplatelet therapy recommendations for DM?

A

75-162 mg ASA daily unless contraindicated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How soon after birth should a newborn be seen in the office?

A

● The AAP recommends that all infants are seen at birth, and then within 3 to 5 days of birth (usually 48 to 72 hours after hospital discharge) to evaluate for feeding problems, jaundice, and provide breastfeeding education and support.

● Infants discharged less than 48 hours after delivery should be examined within 48 hours of hospital discharge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

General nutrition recommendations for DM (4)?

A
  1. Concentrate on healthy options. 2. No advantage to nutritional/vitamin supplements. 3. Limit alcohol (1/day women, 2/day men). 4. Sodium <2300 mg/day.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Exercise recommendations for DM?

A

Children: 60 minutes/day Adults: 150 minutes/week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How often should eye and foot exams happen with DM?

A

Eye = 1x/year minimum Foot = 2x/year minimum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when should new moms be screened for postpartum depression?

A
  • Edinburgh Postnatal Depression Scale (EPDS) should be administered to mothers in the hospital and then at outpatient EPSDT visits through 6 months
  • Screen for maternal depression by 1 month, and at 2-, 4-, and 6-month visits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

BP goals for DM?

A

<140/90. If treated, include ACE/ARB.

17
Q

How often do you check A1C in DM?

A

2x/year if controlled. 4x/year if not controlled or medication is changed or there is significant weight loss.

18
Q

What are initial options for medication in DM?

A

Type 1: Insulin Type 2: Metformin, 2nd PO agent, and/or insulin

19
Q

ADA recommends the first dental exam should occur when?

A

At emergence of teeth or age 1. Not widely practiced. More common to present around age 3.

20
Q

Lipid goals for DM?

A

<70 with CVD risk factors. <100 without CVD risk factors.

21
Q

when should children have their lead level checked?

A

-All children with Medicaid need a lead level sent two times: at 12 months and 24 months.

  • Capillary (finger stick) lead can be used as a screening and venous sample as follow-up.
  • If a child aged 3 to 6 years has not ever been screened they need a lead level sent at least once.
22
Q

when should screening for autism take place?

A
  • Autism surveillance occurs at every visit (through direct observation and asking parents if they have any concerns about their child’s learning, development, or behavior).
  • Formal autism screening is routine and recommended for all children at 18 and 24 months, or at other ages with parental concerns
23
Q

What universal screening is done at the 2-year visit?

A
  • Comprehensive history
  • Autism screening for the second time
  • Unclothed physical exam
  • At age 2, measure height (standing) and not length
  • *BMI calculated starting at this visit and every visit hereafter**
  • *BMI less than 5% → underweight**

BMI 5% to 85% → normal

BMI 85% to 94% → overweight

BMI greater than or equal to 95% → obese

  • Vision screening (instrument-based screening may be used at 12 and 24 months)
  • Hearing screening (ask about concerns)
  • Lab testing and screening
  • Lead level – second one (required if she has Medicaid or if she is otherwise at risk)
  • Start dyslipidemia risk assessment at 2 years old; then at 4, 6, 8, and then yearly. You plan to send a fasting or non-fasting lipid profile once between 9 and 11 years and again at 17 to 21 years as long as they continue to be low risk. If risk factors, send a screening lipid profile now
  • Anemia risk assessment continues
  • Immunizations
  • Health education and anticipatory guidance
24
Q

what screenings is done for every adult, every visit?

A
  • hypertension screening
  • obesity screening
  • depression screening
  • smoking cessation
  • alcohol screening
25
Q

what is recommendation for screening for chlamydia and gonorrhea?

A
  • It is a grade B recommendation for all sexually active women 24 years old or younger to be screened for chlamydia, whether there are other risk factors, and for women older than 25 if there are risk factors.
  • Defined risk factors for chlamydia include age less than or equal to 24 years, a history of chlamydia in the past, a history of any other sexually transmitted infection (STI) in the past, new or multiple sexual partners, inconsistent condom use, and those who exchange sex for money or drugs.
26
Q

What is the recommendation for folic acid and child bearing aged women?

A

-It is an grade A recommendation that all women capable of becoming pregnant or planning pregnancy take a daily supplement containing 400 to 800 micrograms of folic acid daily to prevent neural tube defects in infants during development

27
Q

what is the recommendation for HIV screening?

A
  • Screening for HIV is a grade A recommendation for all adolescents and adults ages 15 to 65
  • A one-time screening for all is appropriate with future screenings for patients with risk factors.
28
Q

what is the recommendation for screening for syphilis?

A
  • Screening for syphilis is a grade A recommendation for persons who are at increased risk for infection
  • Populations at higher risk include men who have sex with men and engage in high-risk sexual behavior, commercial sex workers, persons who exchange sex for drugs, and those in adult correctional facilities
29
Q

What is the recommendation for cervical cancer screening?

A
  • Cervical cancer screening with a Pap smear (cytology) is an A recommendation for women ages 21 to 65 every 3 years
  • For women over 30, screening via cytology and testing for high-risk human papillomavirus (HPV) or via high-risk HPV testing alone is appropriate; if both tests are normal, a 5-year screening interval can be employed.
30
Q

Additional points regarding cervical cancer screening (DO NOT screen these populations)

A
  • D recommendation to screen women under 21 years
  • D recommendation to screen women over 65 with no risk factors
  • D recommendation to screen women under 30 with HPV typing (alone or with Pap)
  • D recommendation to screen women without a cervix who have no history of invasive cervical neoplasm (that is cervical intraepithelial neoplasia (CIN) 2,3 or cervical cancer)
31
Q

what is the recommendation for breast cancer screening?

A
  • If a patient has no increased risk, it is a B recommendation to start mammograms routinely at 50.
  • Teaching self–breast exams is a D and is not recommended. The clinical breast exams that we do in the office are rated an “I” or inconclusive if they are of any benefit
32
Q

What is the recommendation for cholesterol screening for women?

A
  • Grade A recommendation if they are older than 45 years old with increased risk factors
  • Grade B recommendation for women age 20 to 45 years old with increased risk factors
  • Grade C recommendation for women ages older than 20 years old with no increased risk
33
Q

What is the recommendation for screening for colon cancer?

A
  • Screening starting at age 50 is an A recommendation for men and women. Routine screening should continue until age 75.
  • For patients age 76 to 85, colon cancer screening is a C recommendation.
  • For patients age older 85, it is a D recommendation, and they should not be screened
34
Q

The American Cancer Society offers any of the following plans as reasonable for colon cancer screening

A

1) Flexible sigmoidoscopy every 5 years
2) Colonoscopy every 10 years.
3) Double-contrast barium enema every 5 years
4) Guaiac-based fecal occult blood test (gFOBT) or fecal immunochemical test (FIT) every year
5) Stool DNA test (sDNA) every 3 years

35
Q

What is the recommendation for osteoporosis screening?

A
  • The USPSTF updated these recommendations in 2011
  • Osteoporosis screening is a B recommendation for all women age 65 or older, and for younger women whose risk is similar to women at 65 with no risk factors (which is 9.3% 10-year risk of fracture)
  • You can use the FRAX tool to estimate risk to make these decisions, which can be found at: http://www.shef.ac.uk/FRAX/.
36
Q

what is the recommendation for screening for Diabetes?

A
37
Q

What is the recommendation for screening for cholesterol?

A

The recommendation is to use a low- to moderate-dose statin for prevention IF patients are age 40 to 75 AND have one or more CVD risk factors (tobacco use, hypertension, diabetes, dyslipidemia) AND have a 10-year risk of CVD event that is greater than or equal to 10%.

To calculate 10 years CVD event risk requires lipid screening

38
Q

what is the recommendation for hepatitis C screening?

A

-USPSTF recommends screening at periodic intervals for anyone at high risk for hepatitis C infection, and recommends offering a one-time screening for any adult born between 1945 and 1965. (This is because they estimate that 75% of all current cases of Hep C in the United States are in persons in this age range.) This is a B recommendation.

Beyond those born in the above age group (for which only one-time screening is recommended), those in these increased risk groups should be screened periodically:

Persons who use intravenous illicit drugs

Those who received a blood transfusion before 1992

Persons on hemodialysis

Persons born to a mother with hepatitis C

Persons that have been incarcerated

Those who use intravenous drugs

Persons who have had unregulated tattoos placed

39
Q

what is the recommendation for screening for AAA in men?

A

It is a grade B recommendation that all men ages 65 to 75 with a history of smoking, be screened one time for AAA with an abdominal ultrasound.

Simmons NURP 503 Exam 2 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions